Medical billing isn't just about paperwork. it's about You the provider, your staff, and your patients. It is about getting you paid, Quicker and more efficiently.
That's why work with you, and for you, to customize a medical claims processing solution that fits your practice and your mission.
Back to Top
The use of automated technology is very important in today's age of getting insurance claims paid; tools like electronic medical records (EMR), electronic funds transfer (EFT) electronic remittance advice (ERA), real-time adjudication, claim scrubbing services, coding software products and other technology tools are becoming increasingly necessary. However, not all providers can afford to invest in those technologies and some simply don't want to, making outsourcing of the claims process an attractive alternative.
Additionally, while the skill level necessary to get claims paid has risen each year, the skill level of the person performing the task in many provider's offices has remained the same. Insurance claims specialists at Ace Medical Billers LLC utilize much of the technologies mentioned above, typically allowing them to produce better results in less time than the average provider's office.
Ace medical billers can effectively utilize technologies available to them to get claims paid and to fight claim denials. Every day, it gets harder for healthcare providers to collect insurance dollars. Individually, providers have a great incentive to utilize outsourced billing solutions.
Back to Top
Why do I have to face so many claims denials?
We will use Medicare as an example but this could apply to Medicaid or other third party insurance companies as well.
Medicare claims get denied mainly for the following reasons.
Incorrect or missing ICD-9 diagnoses
Incorrect or missing CPT-4 modifiers
Duplicate claim
Additional information needed to process the claim
Claim billed amount incorrect
Incorrect or missing CPT procedure code
Physician's name and/or UPIN missing or incorrect
Incorrect or missing place of service code
Incorrect or missing quantity of services (Service billed without "quantity" noted, or with multiple quantities indicated in error on claim)
Services inappropriately bundled
Back to Top
With the current restrictions placed on physicians from various insurance carriers it is imperative that consistent follow up be made on each and every claim to be sure they are adjudicated properly. Unfortunately this has placed an enormous amount of work on what, is in most cases, an already overwhelmed staff. In practices where a third party billing service is handling these claims, the same problem applies and an aged receivable becomes impossible for even these services to address. Most billing services are compensated on a commission basis and once the claims become aged they are not reviewed to the necessary degree due to cost effectiveness.
Ace Medical Billers will address each claim on an individual basis and take the necessary action in order to have these claims processed. In addition,
Ace Medical Billers will also review and take action on self pay accounts dealing directly with the patients. Patients are addressed with courtesy, respect and professionalism.
Back to Top
Back to Top
